Essay Example on an Explanation of the Differential Diagnosis for the Patient

Published: 2019-10-24 18:46:25
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Most women in the current world suffer from various breast conditions. These conditions appear frequently in the adulthood of a woman. As a result, most women face various conditions in their breasts which make them worried of developing breast cancer. For instance, the 60 year-old woman in the case study shows concern of greenish-black discharge from her left breast for the last one month associated with dull pain and burning with other unusual conditions in her breasts. Consequently, a differential diagnosis has to be taken to establish the exact problem of the woman given that she has breastfed her all children. As such, the first differential diagnosis for this woman is to evaluate the breast mass (Schuiling & Likis, 2013). This first diagnosis is aimed at determining the palpable breast mass. The woman in the case study has to therefore go through this stage to establish whether she has residual mass of accumulated blood in his breasts. This can be done either by performing a diagnostic ultrasound or through surgical methods (Schuiling & Likis, 2013).

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The second differential diagnosis to the woman in the case study is to evaluate the breast for nipple discharge (Schuiling & Likis, 2013). As seen in the case study the woman is seen discharging a greenish substance from her right nipple. Subsequently, it a non-tender 1 cm discharge in the RUIQ is seen from the nipple. The discharge has to be assed using various aspects such as color hormonal evaluation and persistency. This can be done using mammogram and ultrasound and incase of persistency the patient has to be referred to the surgeon. Lastly, the differential diagnosis has to focus on the evaluation of the breast pain (I.C.S.L., 2016). The patient in the case study did not complain of severe pain since her has mammogram scanning was within range. As a result, the patient has to undergo quantitative pain assessment since the breast pain might be difficult to assess (I.C.S.L., 2016).

The Most Likely Diagnosis for the Patient

The best diagnosis for the woman in the case study is mammogram and ultrasound (I.C.S.L., 2016). A mammogram and ultrasound which are done subsequently are mainly used to determine the breast mass, the discharge from the nipples and the appearance of the breast around the nipples. This diagnosis is the best for the patient in the case study based on the following reasons. Firstly, the patient is above 30 years old and a mammogram cannot reveal all the problems the woman is facing in her breasts (Humphrey,Helfand, Chan&Woolf,2015). Fletcher&Elmore(2014) posit that a woman who is above 30 years old with breast conditions has to be diagnosed using this method. The second reason why this diagnostic method has to be used is because the last mammogram diagnosis for the patient in the case study was within the normal range (Humphrey,Helfand, Chan&Woolf,2015). This shows that the method did not reveal all the actual condition of the breasts of this woman since she is currently worried of developing breast cancer.

A Treatment and Management Plan for the Patient including Proper Dosages for the Recommended Treatment

In order to help the woman in the case study to treat her breast condition to enable her evade conducting breast cancer, a systematic treatment and management plan has to be put in place. Firstly, the patient has to be taken under primary care unit (Jackman, Burbank&Parker,2014). At this stage the woman has to undergo breast screening to help establish additional conditions which might not have been established in her explanations. This stage is normally based on a follow up to exhaust all the conditions that might be faced by the patient. Secondly, the patient has to undergo radiology to ensure that other additional breast abnormalities which might not have been established at the primary stage are accurately identified (Kerlikowske,Smith, Ljung&Grady,2013). Thirdly, the patient in the case study has to undergo a surgical operation (Kerlikowske,Smith, Ljung&Grady,2013). This is done in the case where the second stage established a more complicated state of the breast. The second last treatment plan for the patient is a second mammographic screening which is done to evaluate the condition of the breast after the operation (Kerlikowske,Smith, Ljung&Grady,2013). Lastly, the patient undergoes image-directed core needle biopsy (O'Brien&Abukhalil,2013). This done based on the presence of a mammographic and sonographic MRI nuclear in the breast. During this treatment period the patient has to take a percentage of BI-RADS categories 4 or 5 for 5-7 days.

Strategies for Educating Patients on the Disorder

Breast conditions are a disease which can be avoided by various women based on the public awareness. Consequently, in order to educated these women the following strategies have to be put in place. The first strategy is to establish a communication plan so as to enable all the clinicians be involved in the treatment plan (I.C.S.L., 2016). Secondly, the clinicians have to carry out public awareness using platforms such as websites, social media sites, and advertisements and carrying out physical awareness at different places (I.C.S.L., 2016). Lastly, proper documentation has to be done in various hospitals so as to keep a good record of various breast conditions because they can be used by other people suffering from the same condition (O'Brien&Abukhalil,2013).

Conclusion

In summary, close to 900 women across the world are diagnosed with various breast conditions (I.C.S.L., 2016). As such, there is need for various clinicians and the public at large to come together and help save these women. As seen above, there is a treatment plan which can be used to treat various breast conditions so as to avoid developing breast cancer. Women facing abnormalities in their breasts have to visit hospitals for screening as first as they notice the difference in their breasts.

References

Fletcher, S. W., Elmore, J.G. (2014). Mammographic screening for breast cancer. International Medical Journal 348:1672-80

Humphrey, L.L., Helfand, M., Chan, B. K. S., &Woolf, S. H. (2015). Breast cancer screening: a summary of the evidence for the U.S. preventive services task force. International Medical Journal 137:347-60.

Institute for Clinical Systems Improvement (ICSL). (2016). Health Guideline: Diagnosis of Breast Disease. [online]. Available at: <https://www.icsi.org/_asset/v9l91q/dxbrdis.pdf> Retrieved on 30th August 2016

Jackman, R.J., Burbank, F., &Parker, S.H. (2014). Atypical ductal hyperplasia diagnosed at stereotactic breast biopsy: improved reliability with 14-gauge, directional, vacuum-assisted biopsy. Radiology 204:485-88

Kerlikowske, K., Smith, B. R., Ljung, B.M., &Grady, D. (2013). Evaluation of abnormal mammography results and palpable breast abnormalities. International Medical Journal 139:274-84.

O'Brien, P.M.S., &Abukhalil, I.E.H. (2013). Randomized controlled trial of the management of premenstrual syndrome and premenstrual mastalgia using luteal phase-only danazol.International Medical Journal 180:18-23.

Schuiling, K. D., & Likis, F. E. (2013). Womens gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.

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